| Clinical Experience and Results of a Sentinel Health Investigation Related to Indoor Fungal Exposure Eckardt Johanning,1 Paul Landsbergis,2 Manfred Gareis,3 Chin S. Yang,4 and Ed Olmsted5 1Mount Sinai School of Medicine, New York, New York USA; Eastern New York Occupational and Environmental Health Center, Albany, New York USA; 2Cornell University Medical College, Mount Sinai School of Medicine, New York, New York USA; 3Federal Meat Research, Microbiology and Toxicology, Kulmbach, Germany; 4P&K Microbiology Services, Inc., Cherry Hill, New Jersey USA; 5Olmsted Environmental Services, Inc., Garrison, New York USA Abstract
This is a review of exposure conditions, clinical presentation, and morbidity of children and adults with indoor fungal exposure such as toxic Stachybotrys chartarum. Indoor exposure was characterized using different methods including microscopic, culture, cytotoxicity screening tests, and chemical analyses. Clinical case histories and physical and laboratory findings are presented of children (age < 18 years, n = 22 ; mean age 9 years ; 60% females) and adults (age >18 years, n = 125 ; mean age 39 years, 67% females) who consulted an environmental health specialty clinic. In the pediatric patients' exposure history, widespread fungal contamination of water-damaged building materials with known toxic or allergic fungi was identified. Primarily disorders of the respiratory system, skin, mucous membranes, and central nervous system were reported. Some enumeration and functional laboratory abnormalities, mainly of the lymphatic blood cells, were observed, although no statistically significant differences were found. IgE or IgG fungi-specific antibodies, used as exposure markers, were positive in less than 25% of all tested cases. In an evaluation of a symptomatic girl 11 years of age (sentinel case investigation) living in an apartment with verified toxigenic fungi (i.e., S. chartarum) , several health indicators showed improvement after exposure cessation. Key words: allergy, bioaerosol, exposure, fungi, health, morbidity, mycotoxins, Stachybotrys, toxicity. -- Environ Health Perspect 107(suppl 3) :489-494 (1999) . http://ehpnet1.niehs.nih.gov/docs/1999/suppl-3/489-494johanning/abstract.html
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